Case Report
Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
Table 1
Laboratory workup of thrombocytopenia.
| Test | Result | Reference range |
| Complete blood count | White blood cells × 109/L | 6.14 | 4–11,000 | Hemoglobin (g/dL) | 14.5 | 12.0–16.0 | Hematocrit (%) | 43.0 | 35.0–47.0 | Platelets × 103/L | 1 | 150–450 | Complete metabolic panel | Sodium (mmol/L) | 141 | 136–145 | Potassium | 3.4 | 3.4–4.8 | Chloride | 105 | 98–107 | Bicarbonate | 23 | 23–31 | Blood urea nitrogen (mg/dL) | 13 | 10–20 | Creatinine | 1.0 | 0.6–1.1 | Calcium | 8.8 | 8.5–10.5 | Alkaline phosphatase (U/L) | 53 | 40–150 | AST (U/L) | 30 | <35 U/L | ALT (U/L) | 46 | <55 U/L | Total bilirubin (mg/dL) | 0.7 | 0.3–1.2 | Miscellaneous | Hepatitis B surface antigen | Negative | Negative | Hepatitis B core total antibody | Negative | Negative | Hepatitis C antibody | Negative | Negative | Hepatitis C viral load | Negative | Negative | HIV 1/2 antibodies and antigen | Negative | Negative | Vitamin B-12 (pg/mL) | 434 | 210–815 | Folate (ng/mL) | 9.8 | 7.0–31.0 | Lactate dehydrogenase (U/L) | 221 | 125–250 | Haptoglobin (mg/dL) | 137 | 30–200 | Reticulocyte count (%) | 1.71 | 0.70–2.50 | Reticulocyte count absolute | 0.07 | — | Immature reticulocyte fraction | 10.6 | 1–100 | Fibrinogen (mg/dL) | 365 | 150–400 | D-dimer (ng/mL) | <150 | <243 | Protime (sec) | 11.9 | 9.0–13.0 | Partial thromboplastin time (sec) | 32.8 | 25.0–38.5 | Thyroid-stimulating hormone | 4.45 | 0.45–4.50 | Antinuclear antibody | Negative | Negative | Helicobacter pylori | Negative | Negative | Parvovirus B19 Ab, IgG | Positive | Negative | Parvovirus B19 Ab, IgM | Negative | Negative | Epstein–Barr virus (EBV) capsid IgM | <0.2 | <0.9 | EBV capsid IgG | >8.0 | <0.9 | EBV heterophile IgM | <0.2 | <0.9 | EBV viral load | Negative | Negative | IgA (mg/dL) | 249.0 | 63.0–484.0 | IgG (mg/dL) | 838.0 | 540.0–1,822.0 | IgM (mg/dL) | 357.0 | 22.0–240.0 |
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